A Prostate Cancer Computer Aided Diagnosis Software including Malignancy Tumor Probabilistic Classification

Prostate Cancer (PCa) is the most common solid neoplasm in males and a major cause of cancer-related death. Screening based on Prostate Specific Antigen (PSA) reduces the rate of death by 31%, but it is associated with a high risk of over-diagnosis and over-treatment. Prostate Magnetic Resonance Imaging (MRI) has the potential to improve the specificity of PSA-based screening scenarios as a non-invasive detection tool. Research community effort focused on classification techniques based on MRI in order to produce a malignancy likelihood map. The paper describes the prototyping design, the implemented work-flow and the software architecture of a Computer Aided Diagnosis (CAD) software which aims at providing a comprehensive diagnostic tool, including an integrated classification stack, from a preliminary registration of images to the classification process. This software can improve the diagnostic accuracy of the radiologist, reduce reader variability and speed up the whole diagnostic work-up

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

LA ROBOTICA NELLA RIABILITAZIONE DEI DISTURBI SENSO-MOTORI DELL’ARTO SUPERIORE: STUDIO IN PAZIENTI AFFETTI DA ICTUS CEREBRALE

Introduzione. Lo scarso recupero funzionale dell’arto superiore è tra le conseguenze più invalidanti dell’ictus cerebri. La robotica è un possibile strumento riabilitativo dell’arto superiore paretico, fornendo un approccio terapeutico strutturato ripetitivo ed intensivo capace di promuovere la riorganizzazione corticale. Obiettivi dello studio: valutare l’efficacia di uno strumento robotico nel recupero dei disturbi senso-motori dell’arto superiore distale in pazienti con ictus e valutarne l’efficacia nel ridurre la disabilità nelle ADL e nel migliorare la Qualità di Vita. Materiali e metodi. 17 individui in esiti di ictus randomizzati in un gruppo sperimentale (terapia robotica con Amadeo) ed in uno di controllo (terapia convenzionale). Il trattamento prevedeva 12 sedute trisettimanali di 45 minuti. Gli individui sono stati valutati prima (T0), al termine (T1) e ad un mese (T2) dal trattamento. Misure primarie di outcome: Scala del Medical Research Council (MRC); Motricity Index (MI); Nine Hole Peg Test (NHPT); Action Research Arm Test (ARAT); Motor Activity Log (MAL). � � � � � � Misure secondarie di outcome: Amadeo Firefighters (AFF); Valutazione della sensibilità somatica; Barthel Index (BI). Risultati. Al confronto intra-gruppo, il gruppo sperimentale ha mostrato variazioni significative nei punteggi MRC-estensione ed ARAT tra T0 e T2; alla MI e MAL-Amount of Use tra T0 e T1 e tra T0 e T2. Il gruppo di controllo ha ottenuto risultati analoghi eccetto che nella forza di estensione delle dita, dove non mostra miglioramenti significativi. Nel confronto inter-gruppo è emersa una differenza significativa nell’ARAT-Gross movements tra T0 e T2 a favore del gruppo di controllo. Conclusioni. La terapia con robot è in grado di promuovere il recupero della motilità attiva distale dell’arto superiore paretico in esiti di ictus, in particolare nei movimenti di estensione delle dita; la sua efficacia è equiparabile a quella delle terapie convenzionali, proponendosi come integrazione ad esse

Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design: This is a cross-sectional study nested in the “Delirium Day” study, a nationwide Italian point-prevalence study. Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors

EXCESS workshop: Descriptions of rising low-energy spectra

International audienceMany low-threshold experiments observe sharply rising event rates of yet unknown origins below a few hundred eV, and larger than expected from known backgrounds. Due to the significant impact of this excess on the dark matter or neutrino sensitivity of these experiments, a collective effort has been started to share the knowledge about the individual observations. For this, the EXCESS Workshop was initiated. In its first iteration in June 2021, ten rare event search collaborations contributed to this initiative via talks and discussions. The contributing collaborations were CONNIE, CRESST, DAMIC, EDELWEISS, MINER, NEWS-G, NUCLEUS, RICOCHET, SENSEI and SuperCDMS. They presented data about their observed energy spectra and known backgrounds together with details about the respective measurements. In this paper, we summarize the presented information and give a comprehensive overview of the similarities and differences between the distinct measurements. The provided data is furthermore publicly available on the workshop’s data repository together with a plotting tool for visualization